OVARIAN TISSUE TRANSPLANTATION METHOD AND FOLLICLE ACTIVATION METHOD
20210346574 · 2021-11-11
Inventors
Cpc classification
A61L27/3604
HUMAN NECESSITIES
A61K9/06
HUMAN NECESSITIES
A61K9/0024
HUMAN NECESSITIES
A61K35/54
HUMAN NECESSITIES
A61L27/3641
HUMAN NECESSITIES
A61P15/08
HUMAN NECESSITIES
A61P43/00
HUMAN NECESSITIES
C08L89/06
CHEMISTRY; METALLURGY
A61K47/42
HUMAN NECESSITIES
C08L89/06
CHEMISTRY; METALLURGY
A61K38/24
HUMAN NECESSITIES
International classification
A61L27/36
HUMAN NECESSITIES
A61K38/24
HUMAN NECESSITIES
A61K9/06
HUMAN NECESSITIES
Abstract
When transplanting a plurality of ovarian tissue fragments, agglomeration of ovarian tissue fragments is prevented, angiogenesis is promoted, and engraftment rate is improved. When transplanting a plurality of ovarian tissue fragments formed by cutting ovarian tissue into a mammal, and the ovarian tissue fragments are transplanted by an injection step in which collagen gel is injected into a site to be transplanted, using collagen gel with a gel concentration of about 1%, and then a transplantation step in which the plurality of ovarian tissue fragments are inserted into the collagen gel. At this time, each of the plurality of ovarian tissue fragments may be previously encapsulated with the collagen gel.
Claims
1. An ovarian tissue transplantation method in which a plurality of ovarian tissue fragments formed by cutting ovarian tissue is transplanted into a mammal, the method comprising: an injection step of injecting collagen gel into a site to be transplanted; and then a transplantation step of inserting the plurality of ovarian tissue fragments into the collagen gel.
2. An ovarian tissue transplantation method in which a plurality of ovarian tissue fragments formed by cutting ovarian tissue is transplanted into a mammal, the method comprising: an encapsulation step of encapsulating each of the plurality of ovarian tissue fragments with collagen gel; and then a transplantation step of transplanting the encapsulated ovarian tissue fragments.
3. The ovarian tissue transplantation method according to claim 2, wherein the transplantation step includes injecting collagen gel into a site to be transplanted, and then inserting the plurality of ovarian tissue fragments encapsulated in the encapsulation step into the collagen gel.
4. The ovarian tissue transplantation method according to claim 2, wherein the encapsulation step includes, after the collagen gel encapsulating each of the plurality of ovarian tissue fragments is gelled, further encapsulating an entirety of the plurality of encapsulated ovarian tissue fragments with collagen gel.
5. The transplantation method according to claim 1, further comprising a step of administering human chorionic gonadotropin in the range of 5,000 to 10,000 IU after the transplantation step.
6. The transplantation method according to claim 1, wherein the collagen gel contains 5,000 to 10,000 IU of human chorionic gonadotropin as a whole.
7. A follicle activation method for activating follicles in an ovary of mammals, the method comprising: (1) a step of removing an ovary from a mammal; (2) a step of cutting the removed ovary into a plurality of ovarian tissue fragments; (3) a step of culturing follicles of the ovarian tissue fragments; (4) a step of injecting collagen gel into a site to be transplanted; and (5) a step of inserting the plurality of cultured ovarian tissue fragments into the collagen gel.
8. A follicle activation method for activating follicles in an ovary of mammals, the method comprising: (1) a step of removing an ovary from a mammal; (2) a step of cutting the removed ovary into a plurality of ovarian tissue fragments; (3) a step of culturing follicles of the ovarian tissue fragments; (4) a step of encapsulating each of the plurality of cultured ovarian tissue fragments with collagen gel; and (5) a step of transplanting the plurality of encapsulated ovarian tissue fragments into a patient.
9. The follicle activation method according to claim 8, wherein the step (5) includes injecting collagen gel into a site to be transplanted, and then inserting the ovarian tissue fragments encapsulated in the step (4) into the collagen gel.
10. The transplantation method according to claim 2, further comprising a step of administering human chorionic gonadotropin in the range of 5,000 to 10,000 IU after the transplantation step.
11. The transplantation method according to claim 2, wherein the collagen gel contains 5,000 to 10,000 IU of human chorionic gonadotropin as a whole.
Description
BRIEF DESCRIPTION OF DRAWINGS
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DESCRIPTION OF EMBODIMENTS
[0048] Hereinafter, embodiments of the ovarian tissue transplantation method and the follicle activation method according to the present invention will be described. The inventor considered that poor engraftment rate of transplanted ovarian tissue was caused by the transplanted ovarian tissue fragments adhering to each other and hindering angiogenesis, and tested a hypothesis using animal tests.
[0049] Ovary weight and ovulation number per ovary 2 weeks after transplantation were compared between a group in which five mouse ovaries were transplanted together beneath renal capsule and a group in which five were each separately transplanted beneath the renal capsule.
[0050] In addition, expression levels of angiogenesis markers Hif1, VEGF, and CD31 in the transplanted ovaries were measured in each group,
[0051] From these research results, it was clarified that when the ovaries are transplanted together so that the transplanted ovaries are in close contact with each other, the ovary weight is remarkably reduced and the ovulation number is reduced. In addition, it was suggested that, from changes in gene expression of angiogenic factors, high-density transplantation causes ovarian ischemia and compensates for an increase in VEGF, but the effect is insufficient and angiogenesis is prominently reduced.
[0052] Therefore, in order to improve the engraftment rate of the transplanted ovaries, the transplanted ovarian tissue fragments are encapsulated with collagen gel at the time of transplantation so as not to adhere to each other, and transplanted so as not to adhere to each other, the ovary weight, changes in expression of angiogenic factors, the ovulation number, and follicle number at each follicle stage were measured to evaluate whether or not gel combined use ovarian transplantation was useful.
[0053] VEGF is an important factor that induces angiogenesis, but from the above experimental results, it is considered that the production amount of VEGF induced is insufficient to actually induce angiogenesis.
[0054] Therefore, direct administration of VEGF is considered to be effective for inducing angiogenesis, but problems are that VEGF has a short half life and requires frequent administration, and VEGF does not exist as a drug that can be directly administered to humans.
[0055] Human chorionic gonadotropin (hCG), which is used to induce ovulation during infertility treatment, has a long half-life, is known to act on ovarian granulosa cells to promote VEGF expression for a long period of time, and may cause ovarian hyperstimulation syndrome.
[0056] Therefore, it was verified whether administration of hCG before ovarian tissue transplantation could increase endogenous VEGF and improve angiogenic disorders due to ischemia. At this time, since many diseases have almost no granulosa cells in the ovary, the endometrium was proposed as a VEGF production site other than the ovary, and the effect was evaluated.
Example 1
FIG. 1 to FIG. 3
[0057] In this example, the transplanted ovarian tissue fragments were encapsulated with collagen gel at the time of transplantation so as not to adhere to each other, and then transplanted so as not to adhere to each other, and the effect was evaluated.
[0058] Conditions of the collagen gel used in this example are as follows.
[0059] Product name: Collagen gel
[0060] Component: Dissolved in bovine dermis-derived type I (acid-treated) MEM.
[0061] Gel concentration (final): 1%
[0062] Gel formation amount (amount to be added at the time of transplantation): 30 to 50 μl
[0063] By injecting the above collagen gel beneath renal capsule of a mouse with a syringe with a needle and then inserting an ovary into the site, a state in which the ovary was encapsulated with the gelled collagen gel was created.
[0064] When ovary weight and ovulation number were measured 2 weeks after transplantation, the ovary weight recovered 1.5 times and the ovulation number tripled as compared with control without gel (
[0065] Furthermore, when gene expression of CD31 in the ovary was examined, the expression level was significantly increased in the gel combined use transplanted ovary, indicating that vascular network formation was recovered (
[0066] In addition, when follicles at each developmental stage after a second follicular phase in the transplanted ovary were measured, follicle numbers in late secondary follicle (Late Sec), vesicular follicle (Antral) and preovulatory follicle (PO) were increased to almost the same number as control (one transplanted. with intervals), indicating that follicle development was improved (
Example 2
FIG. 4, FIG. 5
[0067] Experiments were carried out under the same conditions as in Example 1, using atelocollagen gel which was permitted to be injected into a human body. As a result, it was shown that engraftment of the transplanted ovary was improved as in Example 1 also when the atelocollagen gel was used (
[0068] Product name: Koken Atelocollagen Implant.
[0069] Component: 1% Atelocollagen (derived from bovine dermis) phosphate buffer solution
[0070] Gel concentration (final): 1%
[0071] Gel formation amount (amount to be added at the time of transplantation): 30 to 50 μl
[0072] As described above, good results were obtained for ovarian transplantation in Examples 1 and 2. However, in an experiment conducted using Corning High Concentration (HC) Matrigel matrix Growth Factor Reduced (Corning, Matrigel is a registered trademark of Corning Inc., USA), components: laminin 61%, collagen IV 30%, and entactin 1%, as collagen gel, the ovary could not be inserted into the transplant site because hardness at the time of gel formation was too loose.
[0073] In addition, experiments were conducted using agarose gel, component: agarose, instead of collagen gel, for gel concentrations of 0.1%, 0.5%, 1.0%, and 1.5%, respectively. However, the gel hardness was too loose to be inserted into the transplant site at concentrations at the time of gel formation of 0.1% and 0.5%, and the gel hardness was too hard to encapsulate a graft after insertion at concentrations of 1.0% and 1.5%.
Example 3
FIG. 6, FIG. 7
[0074] Next, effects of hCG on angiogenesis of transplanted ovaries were verified. One or five mouse ovaries were transplanted together beneath ovarian renal capsule of host mice so that they were in close contact with each other. In addition, 5 IU hCG was administered to the mouse into which five ovaries were transplanted so as to be in close contact with each other 1 hour after ovarian transplantation.
[0075] Ovary weight and ovulation number per ovary 2 weeks after transplantation were significantly increased in the hCG-administered group (
[0076] In addition, when the transplanted ovaries were collected from the mice administered with hCG after ovarian transplantation, and follicle numbers at each developmental stage after the second follicular phase were measured, late secondary follicles (Late Sec), vesicular follicles (Antral) and preovulatory follicles (PO) were increased, indicating that follicle development was improved (
Example 4
FIG. 8, FIG. 9
[0077] Furthermore, induction of VEGF expression by hCG in the endometrium was attempted with an aim of developing a method that would be useful for all patients. The mouse uterus also expresses an hCG receptor (LHR), and its expression level in each sexual cycle was high in early estrus and estrus, decreased from late estrus, and hardly expressed in diestrus (
Example 5
FIG. 10
[0078] In order to investigate effects of induction of VEF expression by hCG in the uterus on engraftment of the transplanted ovaries, one or five ovaries were transplanted into host mice from which ovaries were removed in estrus so that they were in close contact with each other, and hCG was administered after transplantation. As a result, ovary weight and the number of mature eggs per ovary 2 weeks after transplantation increased significantly in the hCG-administered group (
[0079] In each of the above examples, collagen gel was first injected into an ovarian fixation position (site to be transplanted), and then a plurality of ovarian tissue fragments (approximately 1 to 2 mm square) were inserted into the injected collagen gel. As a result, each of the ovarian tissue fragments was dispersed in the injected collagen gel, and each of the ovarian tissue fragments could be transplanted without being in close contact with each other. Preferably, the collagen gel is spread out or the insertion part is slightly squeezed and blended until the collagen gel sets to some extent and the ovarian tissue fragment becomes almost immobile.
[0080] First, each of the ovarian tissue fragments is encapsulated with collagen gel to be gelled, and then the collagen gel may be injected into the ovarian fixation position, followed by inserting the individual encapsulated ovarian tissue fragments into the injected collagen gel. As a result, each of the encapsulated ovarian tissue fragments keeps a certain distance in the injected collagen gel, so that it is possible to efficiently prevent the ovarian tissue fragments from adhering and save labor in transplantation work.
[0081] Incidentally, the same effect can be expected. even if the entirety of individual ovarian. tissue fragments previously encapsulated. with collagen gel is wrapped with collagen gel, and at a time when the entirety is gelled, a plurality of ovarian tissue fragments covered with the collagen gel are transplanted once or in several times. However, it is preferable to previously inject the collagen gel into the ovarian fixation position and then insert individual ovarian tissue fragments into the collagen gel through an incision for injecting the collagen gel because the size of the incision does not have to be changed.
[0082] As described above, according to the present embodiment, encapsulation of the transplanted ovary with collagen gel and administration of hCG at the time of ovarian transplantation can improve angiogenesis in the transplanted ovary and improve ovarian engraftment.
[0083] For a detailed discussion of the follicle activation method, see Patent Literature 1 and Non Patent Literature 1 above, all of which are incorporated herein by reference.